Researching Brain Changes in Multiple Sclerosis

Due to the fact that MS can be difficult to diagnosis, there is currently no cure for the disease. Yet, researchers are continuously studying any changes within the brain in order to find ways to stop the progression of the disease.

In a more recent study published in the medical journal of American Academy of Neurology, researchers found that every single relapse a patient with MS experiences has an effect on their brain reserve. This could explain why individuals with MS have a more difficult time interpreting social interactions.

Sarah Maurer was a young 23-year-old when her body went numb from the neck down. “I couldn’t brush my own hair. I had no control over my hands” she said. Shortly after, Sarah was diagnosed with MS. “I have a harder time picking up sarcasm from my 15-year-old. He says, 'Mom I’m joking’” said Sarah. As she took her medication for MS, her symptoms and relapses persisted. Today, due to recent medical advancements, Sarah takes a new pill that is working wonders for her condition. “When I had my MRI in 2016, I had enhancing lesions and new lesions. And that was scary. I had an MRI in March; nothing enhancing and nothing new” she said. Sarah’s advice to others who are going through the same experiences is to keep on fighting – “I just do my best to stay more than two steps ahead of it. Catch me if you can” she said.

Brain damage and clinical testing

Augusto Miravalle, associate professor of neurology at the University of Florida, stated that currently, there are 15 approved medications that doctors can use to prevent MS from worsening. “With our therapies, we pretty much expect nothing new. So, no new lesions in the brain, and no relapses or no clinical attacks as well as no evidence of disease progression” said Dr. Miravalle. Patients with MS portray abnormalities in their brain’s white matter, which plays a vital role in connecting several regions in the brain’s social network. The study revealed that the more damage the patients had in the areas within the brain, the more likely it was that they would score lower on clinical tests.

A similar study found that subtle changes in the brain could give reason as to why individuals with MS lose their social abilities, that is, their abilities to comprehend what other individuals are thinking and feeling. Researchers from Portugal wanted to understand why individuals with MS have a hard time developing social relationships and why they tend to withdraw from society.

Although this does not occur for every individual with MS, several experts agree that most experience it. “It could interfere with all spheres of social interaction. The ability to interpret other people's feelings and intentions may influence people's ability to maintain a job and their relationships with family and friends” said lead researcher Dr. Sonia Batista, neurologist at the University of Coimbra in Portugal. For this reason, individuals with MS require continuous love and support from those around them.

For the study, the research team analyzed a group of 60 individuals with MS and a group of 60 healthy individuals (all the same age and education level) – not taking into account time of diagnosis or level of disability. All the participants took part in tests in order to determine their social skills based on other individuals’ needs, beliefs, and objectives. For one of the tests, the participants were shown images of individuals’ eyes and were asked to choose one of four words (such as embarrassed or anxious) in order to describe the individual’s feelings. For another test, they were asked to choose one of two words to explain a silent video of individuals socializing with one another. Both groups received MRI scans and diffusion tensor imaging in order to identify changes within the brain’s white matter.

The results from the scans revealed widespread damage, known as lesions, in the white matter of the individuals with MS. Moreover, the individuals with MS scored lower on both interpretation tests. For the image test, the results were 59% compared to 82% for healthy participants, while for the video test, the results were 75% compared to 88% for the healthy participants.

Lower scores in social areas

The study revealed that the more brain damage individuals with MS had, the more likely they were to have lower social scores. “We confirmed that structures in the social brain are affected in MS, and probably that's why social cognition abilities are affected in MS patients. We have to recognize those patients that have these problems so we can help them” said Dr. Batista. She urged doctors to test individuals with MS in order to help them and their families cope with such difficulties.

Tim Coetzee, chief advocacy, services and research officer for the National Multiple Sclerosis Society, named the study to be innovative and significant. “It's a helpful and important contribution to helping us understand the connections between changes in the brain that are associated with MS and the impact that has on people's quality of life and their brain function. What this research does is bridge those changes” said Coetzee. He also stressed that it is worth studying the changes within the brain to determine the association between gray matter brain damage (area in the brain responsible for muscle control, memory, speech, emotions, self-control, decision-making and senses) and social functioning.

Dr. Batista notes that early studies propose administering oxytocin, known as the love hormone, to trigger signals involved in social interaction. Moreover, she stresses that individuals with MS could benefit from the same social programs used to educate individuals with autism and schizophrenia. The next step in the study would be to perform more thorough research and find ways to prevent and treat social challenges among individuals with MS.

Although researchers have not been able to identify the exact cause of MS, there is excellent progress being made in several areas of MS research. A number of researchers are uncovering promising new treatments in order to help MS patients recover after an attack, prevent the formation of new MS lesions, as well as prevent the progression of the disease. Such treatments are being tested in both large and small clinical trials. “There is tremendous research being conducted in the field of MS. Researchers are trying to study what sets up this cascade of immune destruction in the brain in some people and not in others.

A better understanding for the future

What makes one patient have severe disease and another a much milder variant? New drugs are in the pipeline as well as work being done trying to better understand how current disease modifying drugs work. The future in MS research looks promising and I am hopeful that some day we can overcome this chronic disabling neurodegenerative disorder” said Dr. Nitin K. Sethi, neurologist and assistant professor of neurology in New York.

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